Interferon
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Interferon Peripartum cardiomyopathy: case report A woman, aged about 50 years, developed peripartum cardiomyopathy after receiving interferon for Philadelphia chromosome-positive chronic myeloid leukaemia. At age 44 years, the woman had experienced left-sided pleuritic chest pain that resolved in 1 day and, about 1 month later, she began receiving interferon 5MU five-times weekly. About 18 months later, she presented with left-sided chest pain. Cardiac work-up including an echocardiogram showed normal results with an ejection fraction of 60%. The woman received NSAIDs and her pain resolved. About 5 years and 5 months after she started receiving interferon, it was discontinued because she was pregnant. Six weeks after a full-term baby was delivered, she presented to an emergency room with worsening dyspnoea and oedema of her lower extremities. A chest x-ray revealed pulmonary oedema. Sinus rhythm and T-wave inversion in leads 1, aVL, V3 and V4 were revealed by an ECG. An echocardiogram revealed severe diastolic and systolic dysfunction with an ejection fraction of 20%. She received ACE inhibitors, diuretics, digoxin and aspirin. Within 3–4 days, her symptoms had improved. She was discharged with the same medications. She received digoxin and ACE inhibitors for about 2 years. About 3 years and 3 months after interferon was discontinued, an echocardiogram showed an ejection fraction of 47%. Her heart failure medications were stopped, and she was advised not to become pregnant a second time. She remained in good health. Author comment: "[I]nterferon was of concern because it might have caused underlying cardiac contractile dysfunction, which was unmasked by pregnancy. . . it can be a possibility that the heart failure is the result of both the pregnancy and the interferon." Razaq W, et al. Reversible peripartum cardiomyopathy in a patient with prior exposure to interferon. American Journal of Therapeutics 13: 373-375, No. 4, Jul 801043297 2006 - USA
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Reactions 19 Aug 2006 No. 1115
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